OPEN DOOR CLINIC – Infectious Disease Physician, NPI 1174902555

OPEN DOOR CLINIC is a healthcare provider. based in Aurora, Illinois. specializing in Infectious Disease Physician. The NPI Number for OPEN DOOR CLINIC is 1174902555

Main info

Organization
Name
OPEN DOOR CLINIC
NPI
1174902555
Phone
(630) 264-1819
Address
157 S LINCOLN AVE
Authorized Official
MR. DAVID ROESLER EXECUTIVE DIRECTOR
Enumeration Date
19 May 2015
Last Update Date
19 May 2015
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:11State licenses:0Digital endpointsOther names

Provider Addresses for OPEN DOOR CLINIC

  • 157 S LINCOLN AVE

    SUITE K

    AURORA, IL 605054264

    Phone: (630) 264-1819

    Fax: (630) 229-0182

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (583 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050914000576OClinic/Group PracticeIL2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60505)

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Reviews

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Frequently asked questions

Can I use this page to confirm OPEN DOOR CLINIC's NPI?
Yes. OPEN DOOR CLINIC is listed with NPI 1174902555 in the public NPI dataset.
Is OPEN DOOR CLINIC still practicing?
OPEN DOOR CLINIC is currently listed as active in the public NPI registry.
What healthcare role does OPEN DOOR CLINIC hold?
Scheduling teams often label OPEN DOOR CLINIC under Infectious Disease Physician. Clinical services aligned with this taxonomy classification.
Where is OPEN DOOR CLINIC based?
OPEN DOOR CLINIC is tied to Aurora, Illinois in the data we show; additional addresses may exist on the full record.
Is the information about OPEN DOOR CLINIC up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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OPEN DOOR CLINIC

Infectious Disease Physician
164 DIVISION ST
NPI: 1245516939